Car seats should be used to prevent injury or death in children during motor vehicle crashes. When used improperly or for unintended purposes, car seats can place children at risk for injury or death. The objective of this article is to describe patterns of hazardous use of car seats outside the car for infants (<1-year-olds) in the United States from 2003 to 2007.
The National Electronic Injury Surveillance System of the US Consumer Product Safety Commission database was accessed to obtain information regarding car seat–related injuries treated in emergency departments from 2003 to 2007. Injuries sustained during motor vehicle crashes were excluded. Demographic data, type of injury, body location, disposition, injury circumstances, and other pertinent information were extracted and analyzed.
An estimated 43 562 car seat–related injuries were treated in emergency departments from 2003 to 2007. This national estimate was based on a weighted sample of 1898 infants. The average age of these infants was 4.07 ± 2.73 months, 62.4% of the injuries occurred in infants younger than 4 months, and 54.4% occurred in boys. Of these injuries, 49.1% occurred at home, 8.4% of the infants had to be hospitalized, and 84.3% of the infants suffered a head injury. The most common mechanisms of injury were infants falling from car seats, car seats falling from elevated surfaces, and car seats overturning on soft surfaces.
Injury-prevention efforts should be focused on eliminating hazardous use of car seats outside the car. Caregivers should be cautioned against the placement of car seats on elevated or soft surfaces.
Child safety seat out side motor vehicle use
The frequency of injury to infants resulting from the misuse of these safety seats outside the vehicle is under-recognized. Our research group has previously published a study (1) demonstrating that CRS-related injuries outside the vehicle are seen more commonly than those injuries occurring inside the vehicle (i.e. as a result of crashes). This problem is especially pronounced due a large number of potentially serious head injuries that the infant may incur as a result of CRS misuse (1-5). Reported mechanisms of injury include falls while being carried in a CRS, falls from the CRS when placed on an elevated surface, and suffocation resulting from overturning of the CRS on soft surfaces, or increased risk of airway obstruction from the restraint strap (1, 2, 5). The large number of injuries resulting from misuse of CRS outside of the vehicle represents a growing public health concern. We recently able to review Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) database and found out that child safety seat related outside motor vehicles injuries are increasing in Canada.
Efforts to raise public awareness about these dangers should be undertaken in order to prevent the growing number of injuries and deaths that result from the improper use of these devices. Manufacturers might be engaged in prevention efforts, either by engineering and design improvements, or by looking at strategies to educate/warn parents of these potential risks. Parents frequently take guidance from health professionals and pediatricians in particular, in safety matters pertaining to children (6). With increased reports of this potential hazard, national and international professional groups must provide this necessary guidance.
1. Desapriya E. B., Pike I., Singhal A. Analysis of paediatric injuries related to child restraint seats: are children at higher risk of injury outside the vehicle than inside? Int J Inj Contr Saf Promot. 2007;14(3):196-198.
2. Parikh SN, Wilson L. . Hazardous Use of Car Seats Outside the Car in the United States, 2003-2007.Pediatrics. 2010 Jul 5. [Epub ahead of print]
3. Greenberg R. A., Bolte R. G., Schunk J. E. Infant carrier-related falls: an unrecognized danger. Pediatr Emerg Care. 2009;25(2):66-68.
4. Hulka F., Piatt J. An infant in a car seat on a washing machine: epidural hematoma. Pediatrics. 1994;94(4 Pt 1):556-557.
5. Wickham T., Abrahamson E. Head injuries in infants: the risks of bouncy chairs and car seats. Arch Dis Child. 2002;86(3):168-169.
6. Pollack-Nelson C. Fall and suffocation injuries associated with in -home use of car seats and baby carriers. Pediatr Emerg Care. 2000;16(2):77-79.
7. Mulligan-Smith D., Puranik S., Coffman S. Parental perception of injury prevention practices in a multicultural metropolitan area. Pediatr Emerg Care. 1998;14(1):10-14.
Conflict of Interest: